X-RAY Flashcards
What could cause unilateral pleural effusion?
- Infection
- Neoplasm (mesothelioma)
- Rheumatoid arthritis
- Autoimmune disease
- Pancreatitis
- Haemothorax
What is a silhouette sign and when is it seen?
When you lose a margin because adjacent structures have the same density
Pneumonia
What is a sail sign?
Shadow behind the heart resembling a sail
Left lower lobe collapse
What is a luftischel?
Air crescent around the aortic knuckle
Left upper lobe collapse
When do you see a veil-like opacification of the lung?
Left upper lobe collapse
When do you commonly see a meniscus sign?
Pleural effusion
When do you get a very straight fluid level?
Hydropneumothorax
What are the characteristics of left heart failure?
- Batwing pulmonary oedema
- Cardiomegaly
- Kerley B lines
- Dilated upper lobe vessels
- Pleural effusion
What would a large supraclavicular tumour and rib erosions be a sign of?
Pancoast tumour (lung cancer at apex)
What does pneumothorax look like on x-ray?
- Lung margin coming away from the edge of the ribs
- Slight tracheal deviation
- Shifted heart border
What are the loops around the small bowel called?
Valvula conniventes (go all the way across)
What are the loops around the large bowel called?
Haustra (only go part of the way across)
What is a coffee bean on an AXR?
Sigmoid volvolus - sigmoid colon twists on the sigmoid mesocolon
You can’t see fluid filled loops on an X-ray, but if you saw them on CT, what would you suspect?
Diverticular disease - fluid collecting in pouches
If you see a dilated large bowel, with loss of haustra, on X-ray and a history of antibiotics what do you suspect clinically?
Toxic megacolon, from c. diff
What is thumb printing?
A sign of thickened bowel wall, usually due to Crohn’s disease
What is free sub diaphragmatic gas caused by?
Acute perforation (although this could be a sign of recent laparoscopy so important to check in the notes)
What is Chilaidit’s Syndrome?
Interposition of the colon between the liver and diaphragm with associated abdo pain.
It causes pseudopneumoperitoneum - look for haustra to reassure you that gas is contained and not free
What is Rigler’s sign?
(AKA double wall sign)
Abnormally well-defined bowel wall, due to perforation and pneumoperitoneum
What is the 1st line imagine for gallstones/kidney stones?
Ultrasound
What are the indications for abdominal CT?
- Complications (perforations, abscess etc)
- Cancer staging
What are ERCP and MRCP?
ERCP - Endoscopic retrograde cholangiopancreatography (invasive)
MRCP - Magnetic resonance cholangiopancreatography (non-invasive)
They are used in biliary pathogenesis
What are the normal diameters for the small bowel, large bowel and caecum?
3 cm for small bowel
6 cm for colon (large bowel)
9 cm for caecum
This is often referred to as the ‘3/6/9 rule’
What are the features of IBD on AXR?
Thumb-printing – mucosal thickening of the haustra due to inflammation and oedema causing them to appear like thumb prints projecting into the lumen
Lead-pipe (featureless) colon – loss of normal haustral markings secondary to chronic colitis
Toxic megacolon – colonic dilatation without obstruction associated with colitis
